Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview

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2007
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Stress and trauma-associated immunological changes and their implications on health
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BMC Psychiatry. 2007, 7(1), 54. eISSN 1471-244X. Available under: doi: 10.1186/1471-244X-7-54
Zusammenfassung

Background
According to DSM-IV, the diagnosis of posttraumatic stress disorder (PTSD) requires the experience of a traumatic event during which the person's response involved intense fear, helplessness, or horror. In order to diagnose PTSD, clinicians must interview the person in depth about his/her previous experiences and determine whether the individual has been traumatized by a specific event or events. However, asking questions about traumatic experiences can be stressful for the traumatized individual and it has been cautioned that subsequent "re-traumatization" could occur. This study investigated the cortisol response in traumatized refugees with PTSD during a detailed and standardized interview about their personal war and torture experiences.

Methods
Participants were male refugees with severe PTSD who solicited an expert opinion in the Psychological Research Clinic for Refugees of the University of Konstanz. 17 patients were administered the Vivo Checklist of War, Detention, and Torture Events, a standardized interview about traumatic experiences, and 16 subjects were interviewed about absorption behavior. Self-reported measures of affect and arousal, as well as saliva cortisol were collected at four points. Before and after the experimental intervention, subjects performed a Delayed Matching-to-Sample (DMS) task for distraction. They also rated the severity of selected PTSD symptoms, as well as the level of intrusiveness of traumatic memories at that time.

Results
Cortisol excretion diminished in the course of the interview and showed the same pattern for both groups. No specific response was detectable after the supposed stressor. Correspondingly, ratings of subjective well-being, memories of the most traumatic event(s) and PTSD symptoms did not show any significant difference between groups. Those in the presumed stress condition did not perform worse than persons in the control condition after the stressor. However, both groups performed poorly in the DMS task, which is consistent with memory and concentration problems demonstrated in patients with PTSD.

Zusammenfassung in einer weiteren Sprache
Fachgebiet (DDC)
150 Psychologie
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cortisol response, posttraumatic stress disorder (PTSD), diagnostic interview
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ISO 690KOLASSA, Iris-Tatjana, Cindy ECKART, Martina RUF-LEUSCHNER, Frank NEUNER, Dominique J. F. de QUERVAIN, Thomas ELBERT, 2007. Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview. In: BMC Psychiatry. 2007, 7(1), 54. eISSN 1471-244X. Available under: doi: 10.1186/1471-244X-7-54
BibTex
@article{Kolassa2007corti-10847,
  year={2007},
  doi={10.1186/1471-244X-7-54},
  title={Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview},
  number={1},
  volume={7},
  journal={BMC Psychiatry},
  author={Kolassa, Iris-Tatjana and Eckart, Cindy and Ruf-Leuschner, Martina and Neuner, Frank and Quervain, Dominique J. F. de and Elbert, Thomas},
  note={Article Number: 54}
}
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